Title |
Clinically Isolated Syndrome According to McDonald 2010: Intrathecal IgG Synthesis Still Predictive for Conversion to Multiple Sclerosis
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Published in |
International Journal of Molecular Sciences, September 2017
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DOI | 10.3390/ijms18102061 |
Pubmed ID | |
Authors |
Philipp Schwenkenbecher, Anastasia Sarikidi, Lena Bönig, Ulrich Wurster, Paul Bronzlik, Kurt-Wolfram Sühs, Refik Pul, Martin Stangel, Thomas Skripuletz |
Abstract |
While the revised McDonald criteria of 2010 allow for the diagnosis of multiple sclerosis (MS) in an earlier stage, there is still a need to identify the risk factors for conversion to MS in patients with clinically isolated syndrome (CIS). Since the latest McDonald criteria were established, the prognostic role of cerebrospinal fluid (CSF) and visual evoked potentials (VEP) in CIS patients is still poorly defined. We conducted a monocentric investigation including patients with CIS in the time from 2010 to 2015. Follow-ups of 120 patients revealed that 42% converted to MS. CIS patients with positive oligoclonal bands (OCB) were more than twice as likely to convert to MS as OCB negative patients (hazard ratio = 2.6). The probability to develop MS was even higher when a quantitative intrathecal IgG synthesis was detected (hazard ratio = 3.8). In patients with OCB, VEP did not add further information concerning the conversion rate to MS. In patients with optic neuritis and negative OCB, a significantly higher rate converted to MS when VEP were delayed. In conclusion, the detection of an intrathecal IgG synthesis increases the conversion probability to MS. Pathological VEP can help to predict the conversion rate to MS in patients with optic neuritis without an intrathecal IgG synthesis. |
X Demographics
Geographical breakdown
Country | Count | As % |
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United States | 1 | 33% |
Unknown | 2 | 67% |
Demographic breakdown
Type | Count | As % |
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Members of the public | 2 | 67% |
Practitioners (doctors, other healthcare professionals) | 1 | 33% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
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Unknown | 46 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
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Student > Master | 7 | 15% |
Student > Bachelor | 7 | 15% |
Student > Doctoral Student | 5 | 11% |
Researcher | 4 | 9% |
Other | 3 | 7% |
Other | 8 | 17% |
Unknown | 12 | 26% |
Readers by discipline | Count | As % |
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Medicine and Dentistry | 17 | 37% |
Biochemistry, Genetics and Molecular Biology | 5 | 11% |
Neuroscience | 3 | 7% |
Agricultural and Biological Sciences | 2 | 4% |
Chemical Engineering | 1 | 2% |
Other | 4 | 9% |
Unknown | 14 | 30% |